AGE INVARIANCE IN THE FACTOR STRUCTURE OF ADVERSE CHILDHOOD EXPERIENCES ACROSS THE LIFESPAN

Abstract Adverse Childhood Experiences (ACEs) are associated with negative health and well-being across the adult life span. However, it is unclear whether measures of ACEs are equally predictive for adults of differing ages. Using responses from 125,212 adults on the 11-items in the ACEs Module from the 2020 Behavioral Risk Factor Surveillance System (BRFSS), we conducted both an exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Our EFA identified three interpretable factors, including a 3-item sexual abuse factor (α = .80), a 3-item physical/emotional abuse factor (α = .69) and a 5-item household dysfunction factor (α = .64). Results of our CFA supported the 3-factor solution, X2 (DF = 11) = 14.289, p < .001. A series of 1-way ANOVAS examined age differences in childhood adversity, where middle aged adults reported experiencing more sexual abuse relative to younger and older adults, and younger adults reported experiencing more physical/emotional abuse and household dysfunction compared to middle-aged who reported more than older adults. Additional analyses examined the influence of adverse childhood experiences on physical and mental health outcomes, including depression. Our analyses highlight the persistent effect of ACEs across the lifespan and identify a need for intervention resources for younger and middle-aged adults in order to mitigate effects of ACEs at late life.

States, 2. Washington University in St. Louis, St. Louis, Missouri, United States Person-centered palliative care (PC) requires personcentered communication.This study characterized questions asked by persons with neurologic illnesses and their care partners and PC clinicians' responses.We analyzed audio recordings from 38 initial outpatient PC appointments to characterize questions stated by patients and care partners.Based on previous research, we identified two question types: direct questions (typically-phrased, stated to obtain or clarify information) and indirect questions (declarative statements, not phrased as a typical question, made with information seeking intent).We rated the completeness of clinicians' responses on a 4-point scale ranging from 1 (completely addressed question and provided additional information) to 4 (no response).We also coded features of clinicians' responses, including offers of support or action and unprompted recommendations.Patients and care partners asked both direct (n = 442; 79.6%) and indirect (n = 113; 20.4%) questions.More than 60% of all questions were about symptoms, treatment, and lifestyle issues.Clinicians responded to 90.9% of direct questions and 90.2% of indirect questions; their responses to both question types were similar in completeness (median = 1, mode = 1).Clinicians' responses to direct questions included more offers of support or action compared to responses to indirect questions (17% v. 11%).Responses to indirect questions included more unprompted recommendations compared to responses to direct questions (21% v. 9%).Persons with neurologic illnesses and their care partners use different question types to obtain information during PC appointments.Implications include the need for clinician training to effectively respond to different question types and topics.Even with improved prognostic transparency (Chochinov et al., 2000) individuals struggle to acknowledge a seriousterminal prognosis.Patients who acknowledge their condition, however, show less distress and increased end-of-life planning (Ray et al., 2006).Aims were to: (1) examine extent older adults with serious cancer acknowledge their illness, and (2) identify factors predicting acknowledgement.Individuals receiving outpatient palliative care (N=204; Mage=65.78 years; SDage=7.43) completed measures of Symptom Severity, the Patient Dignity Inventory (DPI;Chochinov et al., 2008), and Illness Acknowledgement (i.e., healthy, seriously ill, terminally ill).Participants with Stage 4 cancer were more likely to acknowledge serious or terminal illness than Stage 1-3 patients, X2 (2,181)=12.93,p <.01), though only 31% of Stage 4 patients reported being terminally ill.In addition, ANOVA showed Symptom Severity, F(2, 190) = 9.86, p < .001differed by level of acknowledgement.Those rating themselves as relatively healthy had less severe symptoms than seriously or terminally ill groups.To further predict acknowledgement, DPI subscales were examined.Dependency predicted acknowledgement of serious-terminal illness (Odds Ratio = .75,p <.05).A final model, controlling for age and education, showed Symptom Severity (OR = 1.03, p <.01) and DPI Dependency (OR = .79,p <.05) predicted acknowledging serious-terminal illness versus lack of acknowledgement.Though often relied on in communicating to patients, cancer stage alone may not help older adults with cancer to acknowledge their prognosis.By identifying influences leading to illness acknowledgement, future research can examine positive and negative outcomes during end-oflife coping.Sleep disturbances are documented among older adults, and it is well-known that COVID-19 disproportionately affected older adults.Yet, studies on sleep quality among older adults with dementia, specifically, tend to focus on caregiver sleep.The purpose of this study was to examine sleep quantity and quality among older adults during 2020.Data were taken from the 2020 National Health and Aging Trends study, an annual study of Medicare beneficiaries aged 65 and older.Chi-square tests were used for bivariate analysis, and multivariate logistic regression models were used to assess differences in sleep quantity and quality between dementia and non-dementia older adults in the national sample.Results revealed that during 2020, the year the COVID-19 pandemic appeared in the U.S., older adults with dementia reported less sleep, and lower quality of sleep compared to those without dementia.This study demonstrates that sleep disturbances are significant among dementia patients.Poor sleep has previously been linked to other risks affecting quality of life, such as falls and caregiver stress, and nonpharmacological approaches are preferred for dementia patients given risks associated with psychotropics.Thus, there is a need for further study to explore changes in sleep quality over time, and to develop non-pharmacological interventions to support dementia patients' sleep quality and quantity.Adverse Childhood Experiences (ACEs) are associated with negative health and well-being across the adult life span.However, it is unclear whether measures of ACEs are equally predictive for adults of differing ages.Using responses from 125,212 adults on the 11-items in the ACEs Module from the 2020 Behavioral Risk Factor Surveillance System (BRFSS), we conducted both an exploratory factor analysis (EFA) and confirmatory factor analysis (CFA).Our EFA identified three interpretable factors, including a 3-item sexual abuse factor (α = .80),a 3-item physical/emotional abuse factor (α = .69)and a 5-item household dysfunction factor (α = .64).Results of our CFA supported the 3-factor solution, X2 (DF = 11) = 14.289, p < .001.A series of 1-way ANOVAS examined age differences in childhood adversity, where middle aged adults reported experiencing more sexual abuse relative to younger and older adults, and younger adults reported experiencing more physical/emotional abuse and household dysfunction compared to middle-aged who reported more than older adults.Additional analyses examined the influence of adverse childhood experiences on physical and mental health outcomes, including depression.Our analyses highlight the persistent effect of ACEs across the lifespan and identify a need for intervention resources for younger and middle-aged adults in order to mitigate effects of ACEs at late life.

RISK AND PROTECTIVE FACTORS OF HEALTH/ HEALTH SERVICE USE II
Abstract citation ID: igad104.3019

EVIDENCE OF AGE BIAS ON THE ALTERNATIVE MODEL OF PERSONALITY DISORDERS
Lisa Stone-Bury, Alyssa Premovich, and Daniel Segal,

University of Colorado at Colorado Springs, Colorado Springs, Colorado, United States
Introduction: Previous research established substantial age bias on personality disorder (PD) diagnostic criteria for older adults.The Alternative Model of Personality Disorders (AMPD) is a new model of PDs proposed in DSM-5's Section III that measures PDs dimensionally along two criteria: personality functioning with four domains (measured by the Levels of Personality Functioning Scale; LPFS) and pathological personality traits with five domains (measured by the Personality Inventory for DSM-5; PID-5).This study examined age bias on the AMPD in a cross-sectional design.Method: Older (n = 200) and younger adults (n = 213) completed the LPFS-Self-Report (LPFS-SR) and the PID-5-Brief Form (PID-5-BF).Results: Differential Item Functioning (DIF) analyses were computed on items of the LPFS-SR and PID-5-BF.An item exhibits DIF if two age groups with similar levels of an underlying scale have different probabilities of endorsing an item.Overall, 18 of 80 items on the LPFS-SR demonstrated large DIF.The Empathy (50% of items) and Intimacy (25% of items) domains were most aged biased.For the PID-5-BF, 10 of 25 items showed large DIF.All five domains demonstrated large age bias, with Psychoticism (100% of items) most impacted.Across both DIF models, items showed evidence of being biased for (disproportionately high endorsement of an item) or against (disproportionately low endorsement) older adults.Discussion: Findings indicate meaningful age bias on both AMPD diagnostic criteria, indicating that older adults are at-risk of being underand over-diagnosed with PDs under the AMPD.Revision of the AMPD is warranted to achieve age neutrality.The aim of this study was to identify predictors of longevity using retrospectively coded autobiographical stories written and recorded from N = 1,858 deceased centenarians (M = 102.79years; SD = 2.25 years) from the state of Oklahoma.Using the Developmental Adaptation Model as a conceptual framework, total number of years lived, the developmental outcome was regressed on socio-demographic characteristics including sex, race, and education, as well as retrospectively coded variables reflecting parental occupation, total years married, age at retirement, engagement in international travel, and self-attributions of longevity.Results confirmed three key predictors of living to 100 years and beyond.First, race was confirmed as a strong predictor of longevity (β = −.65,p < .001).Fatherhood agricultural occupation emerged as second key predictor of living 100 years and longer (β = .42,p < .10).Finally, total years spent in a marriage represented a third predictor of longevity (β = .47,p < .01).Results suggest being a person of color, being raised by a father who made a livelihood working in the agricultural industry, and remaining within a long-term marital union are contributing variables linked to living 100 years and longer.Further detail regarding descriptive and methodological evaluation of retrospectively coded centenarian biographies will be highlighted.Results have implications relative to how gerontological researchers and aging service professionals may evaluate and link autobiographical information of long-lived adults to developmental outcomes such as longevity.

EXTREME WEATHER PREPAREDNESS AND CLIMATE ACTIVISM AT AGE 85+
Taylor Patskanick, Sophia Ashebir, Lisa D'Ambrosio, and Joseph Coughlin, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States Current projected shifts in climate suggest extreme weather events and disasters will become increasingly common and severe.Older adults are a population vulnerable to the impact of extreme weather due to complex mobility, health, and financial situations in later life, affecting their ability to prepare for and respond to extreme weather emergencies.These compound vulnerabilities demonstrate the importance of adequate emergency preparedness among older adults, particularly among the oldest of older adults or the age 85+ demographic.This paper shares findings from a mixed methods study with the MIT AgeLab 85+ Lifestyle Leaders panel, a research panel of U.S. octogenarians and nonagenarians, on climate change, including their perceptions of generational contributions to climate change, extreme weather preparedness, and engagement in climate justice.Utilizing a survey (n=23) and five virtual focus groups (n=19) conducted in July 2022, findings underscore differences in themes related to weather-event-related emergency preparedness among Lifestyle Leaders living in senior housing versus those community-dwelling.Additional themes note a perceived lack of individual agency and control around impacting climate change locally (including a potential life stage effect) and the urgency of climate change as a societal-level and voting issue.The implications of these findings for effective engagement with the over-85 age demographic in conversations about climate change and emergency preparedness will be highlighted.